Enhancing seedling production of native species to restore gypsum habitats.

Gypsum habitats are widespread globally and are important for biological conservation. Nevertheless, they are often affected by human disturbances and thus require restoration. Sowing and planting have shown positive results, but these actions are usually limited by the lack of native plant material in commercial nurseries, and very little information is available on the propagation of these species. We address this issue from the hypothesis that gypsum added to a standard nursery growing medium (peat) can improve seedling performance of gypsum species and, therefore, optimise the seedling production for outplanting purposes. We test the effect of gypsum on emergence, survival, and growth of nine native plant species, including gypsophiles (exclusive to gypsum) and gypsovags (non-exclusive to gypsum). We used four treatments according to the proportions, in weight, of gypsum:standard peat (G:S), i.e. high-g (50G:50S), medium-g (25G:75S), low-g (10G:90S), and standard-p (0G:100S). Our results showed that the gypsum treatments especially benefited the emergence stage, gypsophiles as group, and Ononis tridentata as a taxon. In particular, the gypsum treatments enhanced emergence of seven species, survival of three species, and growth of two gypsophiles, while the use of the standard peat favoured only the emergence or growth of three gypsovags. Improving emergence and survival at the nursery can provide a reduction of costs associated with seed harvesting, watering, and space, while enlarging seedlings can favour the establishment of individuals after outplanting. Thus, we suggest adding gypsum to standard peat for propagating seedlings in species from gypsum habitats, thereby potentially cutting the costs of restoring such habitats. Our assessment enables us to provide particular advice by species. In general, we recommend using between 25 and 50% of gypsum to propagate gypsophiles, and between 0 and 10% for gypsovags. The results can benefit not only the production of widely distributed species commonly affected by gypsum quarrying, but also of narrow and threatened endemic species that require particularly efficient use of their seeds. In addition, our study highlights the importance of using appropriate growing media to propagate plants characteristic of special substrates for restoration purposes.

CERAMENT treatment of fracture defects (CERTiFy): protocol for a prospective, multicenter, randomized study investigating the use of CERAMENT™ BONE VOID FILLER in tibial plateau fractures.

BACKGROUND: Bone graft substitutes are widely used for reconstruction of posttraumatic bone defects. However, their clinical significance in comparison to autologous bone grafting, the gold-standard in reconstruction of larger bone defects, still remains under debate. This prospective, randomized, controlled clinical study investigates the differences in pain, quality of life, and cost of care in the treatment of tibia plateau fractures-associated bone defects using either autologous bone grafting or bioresorbable hydroxyapatite/calcium sulphate cement (CERAMENT™|BONE VOID FILLER (CBVF)). METHODS/DESIGN: CERTiFy (CERament™ Treatment of Fracture defects) is a prospective, multicenter, controlled, randomized trial. We plan to enroll 136 patients with fresh traumatic depression fractures of the proximal tibia (types AO 41-B2 and AO 41-B3) in 13 participating centers in Germany. Patients will be randomized to receive either autologous iliac crest bone graft or CBVF after reduction and osteosynthesis of the fracture to reconstruct the subchondral bone defect and prevent the subsidence of the articular surface. The primary outcome is the SF-12 Physical Component Summary at week 26. The co-primary endpoint is the pain level 26 weeks after surgery measured by a visual analog scale. The SF-12 Mental Component Summary after 26 weeks and costs of care will serve as key secondary endpoints. The study is designed to show non-inferiority of the CBVF treatment to the autologous iliac crest bone graft with respect to the physical component of quality of life. The pain level at 26 weeks after surgery is expected to be lower in the CERAMENT bone void filler treatment group. DISCUSSION: CERTiFy is the first randomized multicenter clinical trial designed to compare quality of life, pain, and cost of care in the use of the CBVF and the autologous iliac crest bone graft in the treatment of tibia plateau fractures. The results are expected to influence future treatment recommendations. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT01828905.

Low-cost antibiotic loaded systems for developing countries.

Treatment of osteomyelitis with local antibiotic delivery systems has become a common practice in orthopaedic surgery. This study attempted to show that locally produced pure or bioglass reinforced plaster of Paris, hydroxyapatite and sodium alginate are promising biomaterials and mainly because of economical reasons and availability, may be an alternative in clinical practice, especially for developing countries. A total of 32 rabbits were divided into four groups (n:8). In group A, sodium alginate + cephazoline; in group B, plaster of Paris + bioglass + cephazoline; in group C, plaster of Paris + hydroxyapatite + cephazoline and in group D, plaster of Paris + cephazoline were used. The blood serum cephazoline concentrations were analyzed by high performance liquid chromatography on days 1 to 10 everyday and then at days 13, 17, 18, 24, 25 and 30. The mean values +/- standard deviations and median values of blood serum antibiotic concentrations for groups A, B, C and D were 1.45 +/- 0.40 (1.42) mcg/ml, 1.53 +/- 0.64 (1.31) mcg/ml, 1.92 +/- 0.39 mcg/ml (1.90) and 1.41 +/- 0.65 (1.25) mcg/ml, respectively. The detected antibiotic level was constantly over the minimum inhibitory concentration for Staphylococcus aureus. In conclusion, it can be stated that these materials are promising as a antibiotic delivery system even with simple production methods.